Number of COVID-19 cases: the count is no longer good

Time to read : 3 minutes

Since the start of the pandemic two years ago, each day has brought its share of new COVID-19 cases, a daily figure against which government measures come and go. However, whether in Ontario or other provinces, this quantified version is now widely disputed by experts, even described as unrepresentative. Decoded.

The latest decisions made by the province regarding the count of positive cases for COVID-19 have a lot to do with it. The representativeness of this great indicator, which determines whether a wave of pollution is or is not, with all the resulting measures, is increasingly questioned by the scientific community.

“We have reached a point where our data can no longer guide us from a scientific point of view,” laments Professor Nimâ Machouf, an epidemiologist and professor of public health. For this expert, the official figure for the number of new cases must be multiplied by five if one wants to try to get closer to the reality on the ground.

More than an intuition or a theory, it is a fact. In fact, on December 30, the Ontario Ministry of Education announced, through a memorandum, that following changes aimed at limiting access to PCR tests, cases in schools will no longer be reported and, by rebound , they will no longer be counted.

Moreover, on the same day, the province’s Ministry of Health announced that the province no longer recommends ordinary citizens to take a PCR test, because this detection method is now reserved for certain categories of the population known as “very high risk”. or frontline workers.

For symptomatic people, the ministry now recommends rapid tests, and when the result is positive, isolation at home is advised without going to get confirmation with a PCR test, which means that these positive cases are not declared as such and escape. to the official count.

Rapid tests muddy the waters

“It is a sacrifice that leaves us a little uneasy because it is a little blind. But in the face of Omicron and its meteoric spread, you have to choose which data to sacrifice, and Ontario has chosen to sacrifice absolute case counts,” acknowledges Dr. Santiago Pérez Patrigeon, an infectious disease specialist at Kingston Health Sciences Center before relativize:

“That’s not necessarily a bad thing because it allows public health to focus on the situations and people most at risk. From the beginning, we had opted for a zero-case strategy. Today, with Omicron, which is difficult, even almost impossible to contain, we can no longer do the same. We must focus on real indicators such as hospitalizations and deaths to assess the situation. »

Dr. Santiago Pérez Patrigeon, an infectious disease specialist at the Kingston Health Sciences Center. Courtesy

However, this specialist advances a limit to this “sacrifice”, that of being permanently behind the pandemic. In fact, hospitalizations usually occur two to three weeks after a wave of contamination, whereas, on the contrary, when we tried to count daily cases exhaustively, it was this number that was used to estimate, in advance, the trend. of hospitalizations.

Salvation is in the sewer

However, the horizon is not bleak, as Dr. Santiago Pérez Patrigeon is quite optimistic about the future. Scientific arguments in support, wants evidence of other little publicized, but very useful means of measurement.

“Instead of taking a single large measure, we can take several small ones, certainly indirect, but very representative. Outbreak surveillance is one because you can count all the cases. It is a good indicator of spread and we notice that cases drop considerably in outbreaks, “he explains.

The other important variable that the scientist mentions is the regular analysis of wastewater, since people with COVID-19 also expel the virus in their feces. As a reminder, Ontario has developed a wastewater monitoring program consisting of 170 specific collection points, such as hospitals, wastewater treatment centers, and nursing homes. Here again, the data is encouraging and indicates the beginning of a phase of decline in the spread of the virus.

Finally, at press time, Ontario’s 34 public health offices are reporting 3,424 new cases for 4,008 hospitalizations, which is more hospitalizations than confirmed cases, further proof that this indicator would not be more meaningful.

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